Jock Itch Is Not Fun In The Philippines

Jock Itch Is Not Fun In The Philippines

Trichophyton Rubrum Microconidia 
by Medmyco licensed under CC0 1.0

Table Of Contents:


Tinea Cruris Strikes

Tinea cruris (aka jock itch) is a fungal infection most often caused by the fungus Trichophyton Rubrum. It is likely that I had the infection for weeks before I saw it. I had been working in the hot, humid and rainy environment clearing weeds and grass. I had noticed an occasional tingly mild burning sensation a few days into the work. Most of the time I felt nothing at all. After about two weeks the discomfort level increased just enough to warrant an inspection.

A Dark Red Rash

The blotch was about 2 1/2 inches across with cauliflower lobed edges and an angry red, raised and well-defined border. It was on my inner thigh going toward the perineum. It was horrifying. I quickly made an appointment to see a doctor and I was relieved to discover that what I had was a very common fungal infection. The doctor prescribed Ketoconazole. You do not need a prescription to purchase Ketoconazole in the Philippines and it can be found at most any local pharmacy.

Cause Of The Infection

Heat and sweat combined with chaffing of the skin provided the perfect opportunity for a micro-organism to enter the skin.

It is not possible to stay dry while working outside in hot and humid conditions. Less than five minutes after beginning work I am already streaming sweat. The day-time temp averages 90F with humidity also in the 90% range.

The solution is to always use fresh working clothes and to shower frequently. I also purchased Dr. Wong's Sulfur Soap and use it alternately with regular soap. I use a hair dryer to make sure that the area gets absolutely dry.

Week One Of Treatment

After four days later the Ketoconazole 2% seemed to be working well. I was advised that in order to prevent recurrence I must continue application of the drugs for 5-7 days beyond the point where the redness appears to clear up.

Week Two Of Treatment

The tentative diagnosis for my infection was Trichophyton rubrum.

I now have suspicions that a different microbe could be the culprit.

The reason I doubt the original diagnosis is twofold. First, I noticed the development of satellite lesions. Satellite lesions are red bumps/blisters outside of the main patch of affected skin. Satellite lesions are not supposed to occur with Trichophyton rubrum.

The second sign that I was dealing with something different is the fact that the scrotal area became affected. That is also not common with Trichophyton (though there is some argument).

I could be dealing with Intertrigo complicated by a Candida albicans super-infection.

Last week the infection the infection seemed to be healing due to the Ketoconazole. That did not last. I took my recovery for granted and spent a day working and sweating only to find that the infection has become inflamed again and the angry red border had returned.

That episode shocked me into getting a lot more serious about beating the infection.

For the past five days I have sworn off working and I have remained in the air conditioned room with the fan full blast on the affected area.

I cannot stress enough the importance of positioning a fan to blow directly on the affected area. I do this throughout the day and while sleeping. The redness fades away and the blisters/bumps dry out where the skin is exposed to the blowing air. This is crucial to keeping the infection dry so it can heal, especially in a tropical environment.

I continue to use Dr. Wong’s Sulfur Soap each day. The instructions say that the soap can be used specifically for skin infections. You are supposed to apply the lather and allow it to stay on the affected skin for several minutes. I have been doing that and the area is clearing more every day.

Be aware that overusing sulfur soap will cause irritation.

Despite the setback the skin is much lighter in color now and the angry red border has been reduced to just a few patchy pinkish bumps.

Recovery Is Slow

Generally, the consensus is that clearing jock itch takes around six weeks. It is also very common for there to be re-occurrences. I would guess that this is due to losing patience with treatment. I have only been treating the infection for two weeks and it is a super drag to go to the proper extent necessary to assure complete healing.

It occurred to me that a bio-film could be the reason for such slow and incomplete healing.

A quick search of Google proved that my hunch was correct. Whether I have T. rubrum or C. albicans does not matter. Both fungi produce bio-film.

What Is A Bio-Film And Why Does It Matter?

If you are familiar with the Philippines, then you probably know what nata de coco is. Nata de coco is bacterial cellulose produced by Acetobacter xylinum cultured in coconut water. Nata de coco is a bio-film. If you have ever eaten nata de coco, then you know that it is jelly-like, but also tough. I like to chew it. You will also note the faint scent and flavor of vinegar.

Bio-film matters to those of us with a skin infection because the bio-film insulates the fungal cells. The fungus lives on the skin keratin, so it is already insulated from the immune system by that fact. The bio-film insulates the fungus from anti-fungal medications like ketoconazle.

The bio-film can set up in as little as 24-72 hours.

I had few if any symptoms within that time frame. By the time you experience any real symptom that gets your attention and makes you check out the problem you already have a serious infection dug in and shielded with a bio-film.

The best way to beat that situation is to never get into it in the first place.

Intertrigo and other groin infections get their start with help from us.

By not taking care of our bodies when we are working in hot and humid environments we are playing number one advocate on the side of the fungus.

I will be a lot more cognizant of what is going on where skin meets skin and no more working in the rain or dragging my work day too long without a shower break to wash away the sweat and grime.

Week 10

Finally, after months of dealing with this PLAGUE, every single red dot is gone. Because of the climate and my active lifestyle AND the location of the affected area it was very difficult to get the condition completely resolved.

I am tentatively relieved and happy to say that it seems for the last week that I have completely recovered.

Many times it seemed that I had recovered and then I would do some traveling or spend the day working in the yard only to find that the condition had returned, albeit it just a tiny red dot. But that is how this entire ordeal began - with a tiny red dot. 

My Treatment Summary

This is what worked for me. What works for you is up to you and your doctor.
  • Ketoconazole. Some people may be allergic. **You MUST continue to apply the medication for a MINIMUM of 7 days after all visible signs of infection have disappeared. 
  • Run a fan on the affected area as much as possible to keep it dry.
  • If possible, keep the area uncovered during sleep.
  • Reduce or eliminate sugar. Excess sugar seems to make the infection harder to clear.
  • Maintain a healthy diet to keep your immune system up.
  • Get plenty of sleep. Lack of sleep negatively impacts immunity. Most of the time these infections remain in the keratin and beyond the reach of the immune system, but lack of sleep and poor diet may contribute to creating conditions that the microbes can take advantage of to invade the body.
  • Sulfur soap helped. Overuse can irritate the skin.
  • Dandruff shampoo on jock itch - Don't do it. It irritates the skin.
  • Do not allow the area to remain hot and covered with sweat for longer than absolutely necessary.
  • Shower immediately after work, workouts etc.
  • After showering pat dry and or blow dry the affected skin - not too hot.
  • Allow 4-8 weeks for the infection to heal completely. 
If you do no keep up treatment the infection may never go away and it might get much worse and spread. Just because you cannot see the infection and it seems to be healed does not mean that you are cleared of the infection. Fungal colonies may still be present and those that remain will be the strongest of all, so if you stop treatment prematurely it will be these strongest and most resistant fungi that survive and they will multiply and become an infection that will be much more difficult to beat.

For this reason you must continue to apply the antifungal cream for a minimum of seven days beyond the point that no visible infection remains. Personally, I went 14 days beyond being visibly clear.

It is very difficult to overdose with ketoconazole cream. The amount of the drug present in the cream is a tiny fraction of the amount you will need to take orally if you fail to get the infection under control with the cream.

Foreign Fugitives Cannot Hide In The Philippines

Foreign Fugitives Cannot Hide In The Philippines

all-seeing-eye security camera

UPDATE November 2020

This story is old, but it caught my eye while I was searching for updates. Back in July of this year Michael Kent Clapper was apprehended by the BoI:
Morente said Clapper has allegedly been in an “inappropriate relationship” with a 12-year old girl.The Embassy also stated that Clapper’s US passport already expired, making him an undocumented alien who is subject to summary deportation.“He will be deported for being an undocumented and undesirable alien,” Morente said. 
The story caught my eye because he is being deported without being tried for a crime and, if found guilty, serving a sentence in the Philippines. This would be the way it should happen under the Principle of Territoriality.
The BoI was tipped off by the US Embassy, so one way this could have worked is that Clapper made contact with a minor from the US and then traveled to the Philippines. I have found no news to confirm this. That might establish jurisdiction within the US and maybe there was not enough evidence to do so in Philippines' jurisdiction.
If you have details let us know.

UPDATE September 23, 2020: BI Fugitive Search Unit Nabs Big Fish

Bobby Raquepo, head of BI’s Fugitive Search Unit reported the arrest of American Xavier Fernando Monroy, 63, in Barangay Cacutud Angeles City, Pampanga in a joint operation with the Presidential Anti-Corruption Commission, Philippine National Police PRO-4A, Angeles City Police Office, and US authorities.
Monroy reportedly has an outstanding warrant of arrest issued by the United States District Court for the District of Columbia last May for Conspiracy, Bribery, False Statements, and Obstruction of Justice. 
Xavier Fernando Monroy, 62, a U.S. citizen, was charged in a complaint filed in the District of Columbia with one count of conspiracy to commit bribery, one count of bribery, one count of false statements, and one count of obstruction of justice.

...According to the affidavit, Monroy also provided Kim with confidential and other proprietary, internal U.S. Navy information.  In exchange for the steering of business and the provision of such information, Kim paid bribes to Monroy, including cash, personal travel expenses, meals and alcoholic beverages, and the services of prostitutes.

UPDATE September 9, 2020: Pemberton Freed

US Marine Lance Corporal Joseph Scott Pemberton has been given an absolute pardon by President Duterte. You can be given an absolute pardon once you have served 100% of your sentence. Pemberton has been turned over to BI to arrange his repatriation to the United States.

UPDATE August 17, 2020: Pakistani Bomb Maker's Plans Blow Up

Immigration Commissioner Jaime Morente ordered the BI Legal Division to file charges of immigration law violation against 29-year-old Haroon Bashir, who was arrested last 06 August 2020 at his residence along Atis road, Dacillo Compound, Bgy. San Jose, Puerto Princesa City, Palawan.
“A check of his travel record in our database showed that he arrived in the Philippines on 28 April 2013, and that he never left the country since then,” Morente said.

This guy was able to overstay for seven years when so many others who are not bomb makers get popped much sooner. Just goes to show how good some of these people are at maintaining a low profile. 


UPDATE August 6, 2020: American Fugitive Peter Alex Drier

The US embassy disclosed that Drier has an outstanding arrest warrant issued by the policedepartment in San Diego, California for failure to appear and answer an underlying charge of Assault with a deadly weapon.

It was further learned that Drier was twice arrested last year on charges of Crimes Against Person and Simple Assault by the San Diego police.
Is this the same person in the Lajolla Village News:
Dreier intentionally rammed a three-wheeled police department scooter. Dreier was driving a red Saab convertible and he knocked the scooter over, briefly trapping the San Diego Police enforcement officer inside.
Dreier pleaded guilty in June before Judge Polly Shamoon to assault with a deadly weapon in which he admitted his vehicle was the weapon.

The person who rammed the traffic cop in San Diego is named Peter Alex Dreier.

The man nabbed by BI is Peter Alex, but the last name is spelled Drier.

The man who rammed the cop was 42 when the article in the Village News was published in July 2017 and would be 45 now just like the Peter Alex Drier who was caught by BI.

Both were charged with assault with a deadly weapon in San Diego.

Another idiot who underestimated the all-seeing-eye. 

UPDATE August 6, 2020: Three Koreans Run Clandestine Call Center In Manila

They allegedly deceived the victims by pretending that they are agents of lending institutions,and persuading the former to repay their loans in advance in order to avail of lower interest.

Korean authorities charged that the fugitives amassed from their phishing activities more than80 million won or roughly more than US$67,000, which the unsuspecting victims deposited into the suspects' bank accounts. 
These guys have to be very stupid to think that they can escape notice for long.

American Fugitive Ricky Masanque Sanchez

Ricky Masanque Sanchez was on parole in California for an attempted murder conviction when he had the brilliant idea to run away to the Philippines. My first thought was how dumb this guy is. He was not wanted for anything. All he had to do was serve his time on parole. Why did he run?

It does not matter why he ran, he ran. A lot of people do it. And many of them are far worse than Sanchez. They run to the Philippines thinking that this is some remote, disconnected land invisible to the rest of the world.

They think that they can blend in here in the Philippines. They think that no one will suspect them of being a fugitive. Maybe they are correct in some cases.

If they keep their nose clean they may get by for a while. If they have family that takes care of them and provide some level of cover they might be able to escape justice for a time.

Your Own Face Is Your Worst Enemy

Eventually, you will post on Face Book with your real name or a fake name and your real photo. All they need is your photo and your running days are over.

Or you will walk into some public place that is monitored by cameras connected to facial recognition servers. Boom. It's all over.

In the not too distant future facial recognition will be used by many government agencies throughout the Philippines in order to track down wanted criminals:
Last June, the Philippines’ Defense Secretary Delfin Lorenzana said the country’s military will soon acquire facial recognition software and drones to help in combatting terrorism.

“We are looking at facial recognition software so that we can easily track down the bad guys,” Lorenzana told the media.
Facial recognition capability is being added to 11,000 Thai 7-11 stores:
...Remark will use its KanKan system, which uses gesture recognition to record data on visitor traffic, how long customers spend at each shelf and changes to their emotional state as they move through stores. It will also identify members of 7-Eleven’s loyalty programme, and contains machine learning software enabling it to predict which products should be stocked at particular stores, based on previous purchasing data.
Japan is also exploring facial recognition in 7-11 stores. Can the Philippines be far behind?

One of the first things you do when you enter the Philippines is submit your bio-metrics:
BI Commissioner Jaime Morente noted that they have been using the new software called the border control information system (BCIS) in processing all international passengers entering and exiting the premier ports over the past two weeks at the Ninoy Aquino International Airport (NAIA).

“Each time a passenger’s face is captured by camera and his fingers scanned, the results are automatically cross-matched with the passport image and images in the BI database where personal details of persons with derogatory records are stored,” the BI chief said.
Sanchez came over in September 2017, before this bio-metric policy was implemented.

There are many agencies in the Philippines that are eager to fulfill their mandate as it relates to you. It is only a matter of time before you come up on one of their radar screens:
The new Philippine Identification System (PhilSys) will include all citizens of the country, along with resident aliens, or expatriates, in the country, Socioeconomic Planning Secretary and National Economic and Development Authority (Neda) Secretary Ernesto M. Pernia says, according to the report.
PhilSys will include thumbprint, iris, and facial biometric data, and it was recently announced that the country’s central bank will produce its biometric ID cards.
A pilot of cloud and artificial intelligence-based video surveillance with facial recognition capabilities from Iveda has been successfully completed in Metro Manila, according to a company announcement.
And as if facial recognition was not enough, now fugitives need to be concerned with gait analysis. Shoe stores in Manila are getting people warmed up to gait analysis because it can be used to help you find the perfect fitting shoe. But gait analysis holds the potential to become even more powerful than facial recognition in its ability to uniquely identify individuals.

There Are Eyes Everywhere In The Philippines

Technology does not even need to get involved to end your villainous vacation. 

Immigration Memorandum Circular No. SBM-2014-017 provides for a reward of up to 2,000 PHP for anonymous tips that lead to the arrest of an "overstaying" foreigner.

2,000PHP may not sound like much money to you, but to Filipinos it is easy money for turning in an undocumented, overstaying and or criminal foreigner.

So you can expect the Bureau of Immigration Fugitive Search Unit to show up at your place at any moment.

If The Locals Do Not Get You The Expats Will

Expats who are following the law and doing right do not want to have their good names blackened by bad actors and criminals.

So if you are thinking about fleeing to the Philippines because you think you can just disappear...

think again.

You are not as invisible as you think you are.

Butiki And Tuko Lizards Of The Philippines

Butiki And Tuko Lizards Of The Philippines

Philippine butiki and tuko lizards

Lizards Lizards Everywhere

I took the photo above Saturday morning about 3 AM. The smaller lizard on the left is called butiki and the two big ones are called tuko/tokay. I call the tukos tacos. They make loud called that can be heard for quite some distance that sound like they are saying "tah-ko."

Philippine tuko lizards

In this close-up you may notice that the one on the right is missing part of his tail. The one on the left is likely responsible for the missing tail. They chase one another around and eat the tail. The smaller butiki also engage in this dominance behavior. Only the males will do this and only to other males.

I found this one on the outside of the window at 1AM in the morning:

tuko lizard on window

tuko lizard on window

I went out on our patio one evening and spotted this monster peeking out from the gutter:

Unfortunately, in the poor light and given the distance my camera is unable to focus well upon him.

Wiki says that the tuko lizard is approaching endangered status due to unchecked poaching. These gecko apparently have high black market value. Republic Act 9147 carries a twelve year max prison term with up to a 1 million PHP ($20,000) fine for hunting, collecting and trading these creatures without a proper license.

I personally do not like either the butiki or the tuko very much. The former like to die in my air conditioner creating a horrid stench and forcing me to hose the unit out. We now have aluminum screening around the ACs to prevent this. I have heard stories about them shorting out the circuit board of inverter ACs. The butiki also like to get smashed in the hinge stile of the doors, creating yet more interesting aromas. 

The tuko strike horror into many people. They have very sharp claws and people live in fear of these monsters falling on them. I have no earthly idea what I would do if such a terrible fate were to one day befall me. The tuko also produces copious amounts of foul smelling poop and they are not very particular about where they deposit it.

A Solution For Lizards In Your House

It is possible to be soon overrun by these two denizens of the tropical forest. The best way that I have found to manage them is to employ the age old tool called the "kitty cat." Cats love to eat these things. Lizards are like meth for cats. We have a game where we knock the butiki from the ceilings and walls with a broom and the cats go insane. Cats have an infinite appetite for butiki, it seems.

I had a small cat (he's gone now) that was not much bigger than a large tuko, but he loved to hunt tuko more than anything else. The tuko would battle to the bitter end, but in minutes flat he would be inside of a little cat and that would be the end of it. My cat was never charged.

criminal cat wanted for lizard poaching

Cooking In The Philippines With Liquid Propane Gas (LPG)

Cooking In Philippines With Liquid Propane Gas

LPG Is Necessary But Be Careful 

Just today there was a gas explosion in Manila caused by an LPG leak. Fortunately there are not more explosions like that one. The actual leaking LPG connections and hoses is probably quite common, but environmental factors do not allow the gas to pool in concentrations high enough to explode.

We used to have a bigger problem with leaks when we used the black rubber hoses. They were particularly prone to cracking. I switched to the orange type and immediately noticed that a canister of LPG would last several weeks longer.

I test the connections with a soapy sponge when I replace the canister and every couple of weeks after. The gas had been escaping from tiny cracks in the black hoses, but had not caused a problem since our kitchen has ample airflow to the outside.

LPG Tank And Accessories

We prefer Solane gas. A ~12kg tank lasts us 2.5-3 months with daily use:

It's tough to get into the habit of closing the valve when you are done cooking, especially when multiple people are using the unit throughout the day, but it needs to be done. At the very least it should be closed each night.This will prevent surprise leaks.

When you buy gas for the first time you will have to pay the canister deposit, which is about 2000 PHP ($40). After that you just trade in your empty canister for a full one and that runs about 860 PHP right now. We keep two canisters so we are never without gas for cooking. 

When it comes to picking a regulator I have found that simple and cheap is the best choice. The fancy ones with gauges have never lasted long, but they do cost more. I have not paid more than 170-190PHP for a regulator. Tokina is the only regulator brand we use:

Choosing An LPG Stove 

We have two LPG stoves. The first is a freestanding plain-jane white range:

Freestanding LPG range

We bought our no-frills model 10 years ago for around 18,000 PHP ($350).

These days there is a greater selection of ranges at the mall near us with better units at better prices:

The range above is priced at just under 16k PHP, but I have seen even better units for less. If you live in a bigger city, then you should be able to do very well for both variety and price.

If your tastes are more refined, then you would not have any problem picking up a professional grade unit in most any of the larger cities.

We use the range only when we have a larger item that needs roasting. Our day-to-day workhorse is our counter-top two-burner:

These also come in a wide variety quality and prices. You can find high-end hobs just about everywhere in the Philippines, but we went cheap with a 2500 PHP tabletop unit ($50).

The brand for the stove above is Boston Bay. IMO Boston Bay is overpriced. After five years the stove was needing a replacement, so went with a Hanabishi:

The Hanabishi was 2100PHP. An identical Boston Bay unit was priced at 3900PHP.

Do not expect these little stoves to last long, as they only cost 40-50 USD. If you want something that lasts, then you will need to buy built-in stainless steel hob with stainless steel tubing. Expect to pay tens of thousands of pesos.